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Improving Efficiency in the Laboratory

Anything that is wasteful or has to be repeated is considered inefficient. As healthcare costs continue to skyrocket, it is no surprise that the Institute of Medicine has made ‘efficiency’ one of the six Quality Aims1. Wastefulness in the laboratory can be in tangible form, such as reagents, supplies, and equipment, and in abstract form, such as personnel (and patient) time and energy.

Waste is evident in all steps of the total testing process, but is most prominent in the pre- and post-analytical areas2. Errors in specimen collection, such as a missed collection, wrong tube type drawn, unlabeled specimen submitted, and insufficient quantity of specimen, all lead to repeat collections and waste of supplies and time before analysis. Post-analytically, issues may arise in communication of test results, particularly critical values, when the laboratory professional is unable to reach the appropriate individual in a timely manner, and has to waste time repeating phone calls3. Many of these issues can be addressed with proper training, competency checks, devoted supervision, and prompt error recognition and resolution.

What many laboratory professionals don’t always realize is how much waste can occur at the intersection of clinical care and the laboratory. A sixth consecutive CBC ordered after the first five were normal is wasteful. A clinician ordering an inappropriate test for a given condition is wasteful. A delay in diagnosis or treatment because assistance with result interpretation was not readily available is wasteful. This is just a handful of examples. It is imperative that laboratory professionals communicate with the clinical team to identify areas where improvements to test selection and interpretation can be made, employ information technology to help identify waste and inefficiencies so solutions can be reached, and stay current on the latest best practices to ensure the right patient will have the right test performed at the right time.

1Committee on Quality of Health Care in America. Institute of Medicine. Crossing the quality chasm: a new health system for the 21st century. Washington, D.C.: National Academy Press; 2001.

About The Author

Dr. Stacy Walz is the current Chair of the ASCLS Patient Safety Committee, and has served as a member of the Committee for nearly 6 years. She is the Program Director of a combined MLT/MLS program at Arkansas State University in Jonesboro, Arkansas, and also serves as Assistant Dean for the College of Nursing & Health Professions. She has written and spoken on the topic of the laboratory’s involvement in patient safety initiatives at the state, regional, and international levels.

Lab Testing Matters because…

We as laboratory technicians can and do help the doctors identify the problem/problems that are going on with their patients. Laboratory results are very important in the diagnosis of MANY diseases, cancers and Etc.

When only four years old, I developed a life-threatening infection that was treated effectively only after being tested against multiple antibiotics in a clinical lab. I now help women reach their goal of medical school while teaching in an undergrad college. My colleague, another biology professor, survived meningitis as an infant in part due to the testing performed in a clinical lab.
THANKS!